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转移性肾细胞癌患者对舒尼替尼反应相关的预后因素。

Prognostic factors associated with the response to sunitinib in patients with metastatic renal cell carcinoma.

机构信息

Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.

出版信息

Curr Oncol. 2013 Dec;20(6):e546-53. doi: 10.3747/co.20.1596.

Abstract

OBJECTIVE

We investigated the prognostic clinicopathologic factors associated with overall survival (os) and progression-free survival (pfs) in the once-daily continuous administration of first-line sunitinib in a consecutive cohort of Turkish patients with metastatic renal cell carcinoma (rcc).

METHODS

The study enrolled 77 Turkish patients with metastatic rcc who received sunitinib in a continuous once-daily dosing regimen between April 2006 and April 2011. Univariate analyses were performed using the log-rank test.

RESULTS

Median follow-up was 18.5 months. In univariate analyses, poor pfs and os were associated with 4 of the 5 factors in the Memorial Sloan-Kettering Cancer Center (mskcc) score: Eastern Cooperative Oncology Group performance status of 2 or higher, low hemoglobin, high corrected serum calcium, and high lactate dehydrogenase. In addition to those factors, hypoalbuminemia, more than 2 metastatic sites, liver metastasis, non-clear cell histology, and the presence of sarcomatoid features on pathology were also associated with poor pfs; and male sex, hypoalbuminemia, prior radiotherapy, more than 2 metastatic sites, lung metastasis, nuclear grade of 3 or 4 for the primary tumour, and the presence of sarcomatoid features were also associated with poorer os. The application of the mskcc model distinctly separated the pfs and os curves (p < 0.001).

CONCLUSIONS

Our study identified prognostic factors for pfs and os with the use sunitinib as first-line metastatic rcc therapy and confirmed that the mskcc model still appears to be valid for predicting survival in metastatic rcc in the era of molecular targeted therapy.

摘要

目的

我们研究了与转移性肾细胞癌(rcc)患者一线舒尼替尼每日一次连续给药的总生存(os)和无进展生存(pfs)相关的预后临床病理因素。

方法

本研究纳入了 77 例接受舒尼替尼连续每日一次给药方案治疗的土耳其转移性 rcc 患者,该研究于 2006 年 4 月至 2011 年 4 月进行。采用对数秩检验进行单因素分析。

结果

中位随访时间为 18.5 个月。在单因素分析中,5 个 Memorial Sloan-Kettering Cancer Center(mskcc)评分中的 4 个因素与较差的 pfs 和 os 相关:东部合作肿瘤组(ECOG)表现状态为 2 或更高、低血红蛋白、高校正血清钙和高乳酸脱氢酶。除了这些因素外,低白蛋白血症、超过 2 个转移部位、肝转移、非透明细胞组织学和病理上存在肉瘤样特征也与较差的 pfs 相关;男性、低白蛋白血症、既往放疗、超过 2 个转移部位、肺转移、原发肿瘤核分级 3 或 4 级以及存在肉瘤样特征也与较差的 os 相关。mskcc 模型的应用明显分离了 pfs 和 os 曲线(p < 0.001)。

结论

我们的研究确定了舒尼替尼作为一线转移性 rcc 治疗的 pfs 和 os 的预后因素,并证实 mskcc 模型在分子靶向治疗时代仍然适用于预测转移性 rcc 的生存。

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